HomeMy WebLinkAboutGLACIER VIEW HEIGHTS #4 BLK 2 LT 10
MUNICIPALITY OF ANCHORAGE ,oent
On-Site Water&Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997
http:llwww.mum orglonsite w•
apartment
On-Site Wastewater Disposal System Permit
Permit Number: OSP171098 Effective Date: 6/9/2017
Work Type: Septic Upgrade Expiration Date: 6/9/2018
Tax Code Number: 05050136000
Site Legal Address: GLACIER VIEW HEIGHTS#4 BLK 2 LT 10 G:0159
Site Mailing Address: 22939 EAGLE GLACIER LOOP, Eagle River
Owner: DERRY JAMES S & CHARLENE Y Lot Size in Sq Ft: 43542
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3
This permit is for the construction of:
0 Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions: A percolation test is to be completed prior to construction of the septic field. If the results
require a design change, construction of the system shall stop pending On-site review and approval. Submit
stamped and signed percolation test results with the inspection../ report.
. �
Received By: -. ' • �� //�� // Ce/Q//
�` Date: `e/Q/l
Issued By: MafellieW v / Date: ,..:,./9"/7
MUNICIPALITY OF ANCHORAGE
�a
Community Development Department K:1•11„.„0") Phone: 907-343-7904
Development Services DivisionFax: 907-343-7997
On-Site Water& Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 050-501-36
Property owner(s) JAMES & CHARLENE DERRY Day phone
Mailing address PO BOX 770513, EAGLE RIVER AK, 99577
Site address 22939 EAGLE GLACIER LOOP
Legal description (Sub'd., Block & Lot) GLACIER VIEW HEIGHTS #4 B2 L10
Legal description (Township, Range & Section)
Lot Size 43,542 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field Initial ❑ Single Family (SF)
(w/wo ADU)
Septic Tank ❑x Upgrade Duplex (D) ❑
Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
•
(Signature of property owner or authorized agent)
Permit/Rush Fees: C)(4761 Waiver Fees:
Date of Payment: 6173 I ii Date of Payment:
Receipt Number: c yyG Receipt Number:
Permit No. °Sell 1 O'V Waiver No.
Permit App_ :_
Pannone Engineering Services ac
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail:steve@panengak.com
June 6, 2017
Subject: GLACIER VIEW HEIGHTS#4 B2 L10
Septic System Permit Request
Design Narrative
This is a design narrative for a permit to install an upgrade septic system to be issued for this property. The
proposed system will serve an existing three (3) bedroom house. Currently the lot is developed. The
system will utilize a new 1000g septic tank and a drain field. This lot and the surrounding developed lots
are served by private wells. There are no wells within 100' of the proposed septic system.
I. Soils. One test hole was performed in the vicinity of this system in April of 1984, and groundwater was
monitored for at least seven days. Ground water was not observed to a depth of 9.5' below the surface
in the test hole monitor tube in April 23 of 1984. Bedrock was not encountered in the test hole to
12.0'. PES will conduct a second test hole during time of construction. Based on the results of the
percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square was used
for a conventional system in the area of the test hole.
2. Soil Absorption System Design.
a. See Sheet 1 of the design package.
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field.
The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage
ditches.
4. Topography: The existing topography on the lot generally slopes from north to south, with a slope
of approximately 15-20% in the area of the drain field. There are no steep slopes within 50' of the
proposed drain field. The proposed drain field will maintain 50' separation all steep slopes.
5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that
the review is complete and that there are no further comments is received from MoA On-Site Department,
the note will be removed and "Issued for Construction" drawings will be issued.
The proposed installation will not affect the future development of this or the surrounding lots.
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
/ 9r
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\ TRUE NORTH tiiii SCALE : 1
W
Fq�C INSTALL ABSORPTION FIELD( \
6OLFx5.0'Wx1.5'E.D.,4.5'T.D.
w/ MTs AND COs AT ENDS \
/
R&R 1000G SEPTIC TANK 41
DCO Sc QUANU-FLOW M \
TH-PES P DV AFTER\ANK(P)
TBP 0 CONSTRUCTION N
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M 47
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DESIGN PARAMETERS \ AA
PRIMARY SEPTIC SYSTEM W / \
NO. BEDROOM: 3(450 gpd)
TANK SIZE: 1000g , -
PERC RATE: 1-5 MPI10, '
SOIL RATING: 1.2 GPD/SF W
'AREA RQD: 375 SF
REDUCTION FACTOR: 0.78 ABBREVIATIONS
ADJ ABSORPTION AREA: 292.5 ?? —w wenWATER LINE / TH TEST HOLE
SYS. TYPE: WIDE TRENCH 1.5'ED (., WELL RADIUS (P) PROPOSED
MIN LENGTH: 59 LF ti� EXISTING
Q ci.., -
USE: —ss \ MT NEW SEPTIC CO CLEAN OUT NO.
6OLFx5.0'Wx1.5' E.D., 4.5' TD MT MONITOR TUBE NO.
TOTAL AREA: 300 SF TYP TYPICAL
�\ Date
NOTES: PANNONE ENG SVC, LLC
FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, A99510 #G ++ 05/18/2017
PHONE (907) 272-8218 FAX (907) 272-8211 .y Scale
- *I . II. ‘ ..* 1" -- 50'
GLACIER VIEW HEIGHTS #4 B2 L10 , •�" �• P.I.D. NO
t- ' '1�I _ 050-501-36
SITE: 22939 EAGLE GLACIER LOOP -seven . •onno PERMIT NO.
DRAWN JRL JAMES & CHARLENE DERRY , 1*3OSP171098
PO BOX 770513 .� :�'o` Sheet
SITE PLAN EAGLE RIVER, AK 99577 1 OF 2
SPECIAL PROVISIONS TO SPECIFICATIONS
1 ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON—SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55.
2. SCOPE OF WORK: INSTALL NEW 1000g SEPTIC TANK, AND SOIL ABSORPTION SYSTEM.
3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 9.5 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL
TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 9.5 FEET BELOW
EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY.
4. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC
LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED
SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK.
5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED.
6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES.
7. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING
AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER.
8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE
CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN.
9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE
ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND
TANK ELEVATIONS.
10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION,
TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING.
11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE
PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER
(OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE
CONTRACTOR.
12. THE CONTRACTOR SHALL SIGN THE FOLLOWING:
I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE
ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS
CONSTRUCTED.
CONTRACTOR:
BY: . TITLE:
DATE: .
NOTES: PANNONE ENG SVC, LLC Dote
FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 � G 0s 1s 2017
PHONE (907) 272-8218 FAX (907) 272-8211 Scale
*; • 1g - NTS
GLACIER VIEW HEIGHTS #4 B2 L10 . ._�• �.5 P.I.D. NO
—
SITE: 22939 EAGLE GLACIER LOOP E 0sa36
DRAWN JRL JAMES & CHARLENE DERRY View A. Pannone PERMITT sol NO.
�'.� OSP171098
DESIGN NOTES PO BOX 770513 Sheet
EAGLE RIVER, AK 99577 � 2 OF 2
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
I ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPI=CTION REPORT
'"~AM E PHONE
/~d.-~ ~ ~t~ ~ ~ ~ ~'~(~ ~ --.~_~ ~UPGRADE
MAILING ADDRESS
~[GAL DESCRIPTION
LuCATIO~ NO, OF BEDROOMS
~ DISTANCE TO: Well /~ ~ / Absorptio~a/ ~ / Dwelling ~ / PERMITNO.
~ ~ Manufacturer Material No, of compartmen~
Liq. capacity in gallons
/ 2 ~ I F HOMEMADE: Inside length Width Liquid depth
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
_J ~Z
::O _ Z ~ Manufacturer Material Liquid capacity in gallons
~ Well / Foundation Nearest lot line ~'~/ PERMITNQ.
~ DISTANCE TO: /~ ~ ~ /
:j~' ~,~'' NO, of lines / Length of each~inez.¢ / Total lengthx~of lines/ Trench widths~ / ~ Dis'anco be~s
~'~1 ~ Top of tile to finish grade ~ / Material be~ath tile ¢/ Total effective absorption area ..
Length Width Depth PERMIT NO,
~ ~ ~ype of orib Grib dim~eter Grib depth Total effective absorption area
m Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO.
J
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS
f
INSTALLER
REMARKS
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F1F:' P l. i C F:II",!"I"' x'fir:~tl":l N
PERFORMED FOR:
LEGAL DESCRIPTION:
1
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3
4
5
6
7
8
9
10
11
12
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15
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2O
COMMENTS /~o /C'-~' ,-'~ 3'L
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
[] PERCOLATION
TEST
SLOPE
DATE PERFORMED: ,/~yJ'-/ '/ / ~ /~:~'.~;'~
SITE PLAN
WAS GROUND WATER ),//~..
ENCOUNTERED? ./ 0
/o'','/, ~/.~_.~_. P
IF YES, AT WHAT" /
DEPTH? ~,$'
Reading Date Gross Net Depth to Net
Time Time Water Drop
PEt:t~r~A I ~o N RATE
TEST RUN BETWEEN FT AND FT
· ~ / Ac
PERFORMED BY:
CERTIFIED BY:
DATE:
72-008 (6/79)
HUNICIPALITY OF Rf.,ICHC'~-'RGE
.r.:,EPRRTMENT O, HE:Al_TH AN[.', ENVtROhlHENTRL F..JTECTION
825 L STREET., RNCHORAGE., RK S.~95~']±
264-4720
C] I"-;1 -- $ ][ ',r E 1-4 E ~_ L. F' E F." t~.'l ][ T'
PERMIT NO:
DATE ISSUED:
840474
06,-"i8,.-'84
APPLICANT:
FE.',[:,R E SS:
CONTACT I:'HONE:
CHAHBERS CONST. INE:.
P.O. BOX 77-±450
EAGLE RIYER., AK 99577
99577
LEGAL DESCRIP:
I...OT SIZE:
SUBDIVISION: GLBE:IER VIEW HTS.
SECTIOH: Z6 TOWNSHIP: ±4N
;LA (S~.FT. OR ACRES)
LOT: i0
RANGE: lb.I
BLOCK: 2
I CERTIFY THAT:
I. I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND, WELLS RS SET
FORTH E:Y THE MUNICIPALtT~ OF ANCHORAGE (MOB) AND THE STATE OF ALASKA.
2. I WILL INSTALL THE '.BYSTEH IN ACCORDANCE WITH ALL. MOA CODES AND REGULATIONS.,
AND IN COMPLIANCE WITH THE DESIGN'CRITERIR OF THIS PERMIT.
2:. I WILL A[:,HERE TO ALL MOA AND STATE OF RLRSKFI REQUIREMENTS FOR THE SET BACK
DISTANCES FROH ~NY E',qISTING WELL., WRSTEWRTER DISPOSAL SYSTEM OR PUBLIC
SEWERAGE .SYSTEM ON T~ ~: ANY AE:,.]'RC:ENT OR NEARBY LOT.__-
RF'F'L~CRNT: CHRI"IB~:S ~ONS~T,_ INC.
by
DOC Co, dba
SULLIVAN WATER WELLS
P.O, BOX 272, CFIUGIAK, ALASKA 99567 · TELEPHONE688-2759
OWNER OF LAND
LEGAL DESCRIPTION/o T' ~ 0 t$~ & r~
DATE Started <-/ /~t~'
- Ended
PERMIT NUMBER
DEPTH OFWELL &/?
STATIC LEVEL OF WATER FT.
DRAW DOWN FT.
GALS. PER Hi{
KIND OF CASING
,.~ 5'"
g-¥ o 0
KIND OF FORMATION:
From C~' Ft. to ~'~
From r,~ Ft. to ~') I Ft.
From __ Ft. to.__Ft.
From '*~/ Ft. to~Ft.
From Ft. to Ft.
From c)~"" Ft. to 3~:' .Ft~
From. J~ Ft. to ~1%7 Ft.
From 4.~ Ft. to ':~,~ Ft.
From<:~ Ft. to / t ~ Ft.
Fromt/ O Ft. to IJ~ Ft.
From /~%5 Ft. to /
From Ft. to FI.
From /~*/ Ft.
From ~} / ~ Ft.
From Ft.
From Ft.
t
Frmn Ft. to.__Ft,
Frmn__Ft. to __Ft.
From__Ft. to. Ft
From__ Ft. to. __Ft,':
From__Ft. to. _Ft,
From Ft. to. __Ft..
From Ft. to..__Ft,
From__Ft. to. Ft.
From FI. to Ft.
From FI. to .... Ft.
From Ft. to .... Ft.
From Ft. to___Ft
From Ft. to Ft.
From Ft. to_ Ft
From Ft. to_ __Ft,
From Ft. to .... Ft
From__Ft. to
From Ft. to,__Ft
MISCL. INFORMATION:
B L'
Municipality of Anchorage 0,
TG
On -Site Water and Wastewater Program a
(907) 343-7904 s a E T Y
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 050-501-36 Expiration Date:
1. GENERAL INFORMATION
Complete legal description Glacier View Heights #4 Block 2 Lot 10
Location (site address) 22939 Eagle Glacier Loop, Eagle River, AK _
Current Property owner(s) James & Charlene Derry Day phone
Mailing address PO Box 770513 Eagle River, AK 99577 _
Real-Esta±e-Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
❑
Community Class _Well
❑
Public Water System
❑
Waiver/Variance request for:
3
TYPE OF WASTEWATER DISPOSAL:
Individual
Holding Tank
❑
Community
❑
Public Sewer
❑
Received by: _ _ Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee$_ j 0
Date of Payment
Receipt Number
Waiver. Fee $
Date of Payment
Receipt Number
COSA # Os_C 22 1036__ Waiver #
Distance:
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm ARCTERRA CONSULTING, INC.__,___ Phone 696-61.1.1.____..
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date /71Z__
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition
of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface
conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate
during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are
subject to these various and dynamic characteristics and are outside the control of the
evaluator of the well and septic system. Therefore,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future -40- -4
occupants or can ArcTerra guarantee that no unseen
encroachments, deficiencies or discrepancies exist. �7T�,-
1 1 1
_ � A !a
6. DSD SIGNATURE
System #1 Approved for bedrooms.
0
System #2 Approved for bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the foll
lllt(((i(irr�
ON-SITE �v
111/4Tcn n .
�m WAST!- v I z
J � PROGRAM
<0,
L=--
��))))
Original Certificate Date: 7Z— W202 -,?--
The
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 10-10-12.doc
Legal Description: Glacier View Heights #4 Block 2 Lot 10 Parcel ID: 050-501-36
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 4/84
Total depth 219.5 ft
Cased to 219.5 ft
Sanitary seal is functioning correctly
IN Wires are properly protected
Casing height (above ground) 27 in.
Date of flow test for COSA 1/24/22
Static water level at beginning of test 34 ft.
Comments
B. TANK DATA
Age of tank(s) 4 years
Tank type/material Septic/Steel
Measured operating fluid level in septic tank 49"
Standpipes/foundation cleanout per record drawing
Date of pumping 8/18/21
D. ABSORPTION FIELD DATA
Which system tested (date installed) 24/28/1.7
ALL standpipes present per record drawing
Total measured depth from grade 7.75 ft (max)
Measured depth to pipe invert from grade 6.25 ft (min)
❑ NIA — pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective
Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
Structure served by this system
Well production at time of test 4.1 gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes 0 No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Arcterra Consulting
Date of Sample 1/24/22
[FT STATION
❑
Req_u1h<rnainb
Age of lift station
Lift station material
Comments:
nce completed
years
Adequacy test date 11/24/22
Results Q✓ Pass For 3 bedrooms
Fluid depth prior to test 0 in
Water added 450 gal
New depth 4 in
Elapsed time 10 min
Final fluid depth 0 in
Absorption rate 450+ gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
® Yes
if No
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
Z Yes
if No ft
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25'Z Yes
if No ft
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No ft
Neighboring Absorption Fields > 100'
if No
ft
Animal Containment > 50' ® Yes
if No ft
® Yes
if No
ft
ft
If septic tank is under driveway comment below
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
® Yes
if No
ft
Surface Water > 100'
® Yes if No ft
Property Line > 5'
® Yes
if No
ft
Wells on Adjacent Lots:
® Yes
Absorption Field > 5'
® Yes
if No
ft
Private Wells > 100'
® Yes if No ft
Water Main > 10'
® Yes
if No
ft
_ _ Community Wells > 200'
® Yes if No ft
Water Service Line > 10'
® Yes
if No
ft
If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
® Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100' ® Yes if No ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No ft
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that / have determined through field inspections and review
of Municipal records that the above systems are in conformance with
MOA COSA guidelines in effect on this date.
COSA Checklist yellow sheet
Lot 9 lb 110
h�
.N16
Chimney
d Septic vent (typ)
�8
coo ,36S�e
00
SCALE: V= 50'
gyp' 8496X
sQ
0 �7 � "yO
LOT 10
2.0 OH
Femme
douse
N v
, ', 24.0 u
AsPhalt
4, 72
Rte.•.
49th
•% 00
,4 �-Elizabeth Walatka
so
8036 — L5 , • ���
5AW
esslwP-
S�-
oa'
co
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Lot 11
Revised 7-18-21!
AS -BUILT NW'OERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's inspection
in accordance with ASPLS Standards of the following
described property: LOT 10, BLOCK 2.
GLACIER VIEW HEIGHTS UNIT No. 4
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto, that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways, transmission lines or other
visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
/ this 24th day of JUNE 2021.
EASEMENTS OF RECORD, OTHER THAN ~ l y �!
THOSE SHOWN ON THE RECORDED FRED WALATKA & ASSOCIATES, L.L.C.
PLAT ARE NOT SHOWN HEREON BE Engineers and Surveyors
UNLESS OTHERWISE NOTED. FB 21-3, pg 35-36 907-248-1666
This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary
survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to
establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original
client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered,
the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product.
MUNICIPALITY OF ANCHORAGE
DEPAR'rMENT OF HEAL'I-~I & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
.~0 [ ~ .2>~ '..' NAA #
1, GENERAL INFORMATION
Complete legal description (~/?rCt[:~(~ ~//'L~," '/'/'/~ -~ '
MAR 2 4/1998
Location (site address or directions)
Property owner (-~?¢-LEI~C '~.~--¢-~",/
Mailing address '~,. ~.50~ '0~l'~
Day phone
Lending agency /'
Mailing address
Day phone
Address ,'""~
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: -"~ ~'
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation frorn State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Fronl MOA #21
5, STATEMENT OF INSPECTION BY ENGINEER
As cerlified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/orwastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
Address
Engineer's signature
ordinances, and regulations in effect on the date of this inspection.
Alaska Water & Wastewa/t~er
Name of Firm 7320 East Chester Hts.~ixc~e Phone
I
DHHS SIGNATURE
V Approved for ~'~'~-~" bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
By: . Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72~25 (Rev. 1/91) 8~ck MOAi¢21
Municipality of Anchorage /~AR
DEPARTMENT OF HEALTH & HUMAN SERVICES"
Environmental Services Division ~', ~-
825 L Street, Room 502 · Anchorage, Alaska 99501 · (9
Health Authority Approval Checklist
Legal Description:~'LRCt~P-- ~E~;,~ i~l{s t'~/'f! ~/0¢,,,~.~. Parcel I.D.:
A. WELL DATA
Well type ~tU~-~ If A, B, or C, attach ADEC letter. ADEC water system number
Log present CC/N) V~; Date completed ~d /~q~
Total depth ~)_~¢1.~5 f Cased to ¢'2~-lc[i-~
Sanitary seal ~'/N) ~'/¢~
Casing height (abeve ground)
Wires properly protected~'~¥/N) _
Date of test
Static water level
FROM WELL LOG
AT INSPECTION
Well production
g.p.m,
WATER SAMPLE RESULTS:
Coliform /~
Date of sample: .3/1"//~'~
Nitrate
o ~, ~/~ (~L)
Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed '~-I,-~t,~q Tanksize [O¢)66,~¢NumberofCompartments ~)~' cleanoutsCN)
Foundation cleanout~N) _ ~ Depression (Y/N) High water alarm (Y~.
Date of Pumping ~!1~1~ Pumper ~¢,~'
C. ABSORPTION FIELD DATA
Date installed
Length ~O ~ Width
Effective absorption area '~'~.'~'
Date of adequacy test
Fluid depth in absorption field before test (in.);
Fluid depth I~1/~¢-- (ins) Minutes later:
P~'oxlde treatment (past 12 months) (Y/N)
Soil rating (g.p.d./ff2 or.m)
Gravel thickness below pipe
Monitoring Tube present ~/N)
Results (Pass/Fail) ~'¢rc'~
System type WIDE
Total depth ¢/tWT
__ Depression over field (Y/N) __
For _
Immediately aft~~ gal, water added (in.): __
Absorption rate = '¢1'~-O ~ g.p.d,
If yes, give date
bedrooms
72-026 (Rev. 3/96)*
LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm leve.~~~
*Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
"Pump off" level at*
On adjacent lots [,~
On adjacent lots
Public sewer manhole/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
/
Foundation ~' (' '(- Property line ,.~ 4- Absorption field ~ ~'
Water main/service line '/(~ fY' Sudace water/drainage LO0 ~ Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line Building foundation /O {-(- Water main/service line
Surface water /,Oo '4- Driveway, parking/vehicle storage area
Curtain drain i'~O.¥'3'~-- ~'k~ o',~,-~ Wells on adjacent lots
ENGINEER'S CERTIFICATION
I ceRify that I ha~e~ine~th¢ ~ld inspections and review of Municipal r~¢SrCs',th~t~h~¢¢~ms
Signature ~ ~~ ~ ~
Engineer's Name/ Cv ~
Date ~/~Z~ ~8 ¢'~ ¢'' ~'
HAA Fee $. ~00.00
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
7320 East Chester Heights Circle ~ Anchorage ~ Alaska 99504
March 17, 1998
Charlene Derry
P.O. Box 770513
Eagle River, Alaska 99577
Subject: Retest of Septic System.
Phone (907) 337-6179 ~ Fax (907) 338-3246
Consulting Engineers
MUNIcIPALFI y 0i- ~NClt0~IAGE
~A[~ 2~ 1998
Lot 10, Bk 2, Glacier View Height~ ~4
Dear Ms. Derry:
Per your request we performed another adequacy test on your septic system 30 days after it was
chenfically treated with Septiclear. The results of the adequacy test are summarized as follows:
On the day of our inspection there was 6 inches of liquid in the sump. Seven-hundred and fifty-six
(756) gallons of water was introduced over a period of 162 minutes. The fa'st 570 gallons caused
the level to rise 10.5 inches, to a total depth of 16.5 inches, which corresponds to 54.3
gallons/inch. The next 186 gallons caused a rise of only 1.5 inches (full to drainpipe invert),
which corresponds to 124 gallons/inch. Two-hundred and forty-eight (248) minutes later the
liquid level had dropped 2 inches, indicating that approximately 210 gallons had been absorbed.
Two and one-half hours later the level had only dropped an additional l/2 inch, indicating that the
absorption rate had dramatically declined. In smmnary, based upon the aforementioned data, it
was determined that the septic system meets the M.O.A absorption requirements for a 3 bedroom
house (450 gpd), however, it should be noted that it had to be filled to 100% or its capacity in
order to achieve this absorption rate. If you have any questions, please contact me at 337-6179,
or 244-9612.
Sincerely, !
Prin.Jeff~ )al ~ j~'(( ~ }mess, P.E., M.S.
NOTE: The adequacy of a septic system is influenced by numerous.factors, including, but not
limited to, seasonal surface water infiltration, groundwater variations, septic system
maintenance (frequency of septic tank pumping, usage of biological additivea9, condition of
drain pipe and pipe joints (which can be damaged by seismic activity and deteriorate with age),
type of substances deposited in septic aystem (cigarette butts, sanitary napkins, misc. objects),
and the amount of water being introduced on a continual basis. Consequently, the results of this
adequacy test are only valid for the specific day of the test. Furthermore, because of the limited
nature of this investigation, it is possible that there are hidden defects' which may not have been
detected. No warrantee ia' made regarding the future performance of this septic system
Al{as]ka W telr & Wa tcw t¢lr
7320 East Chester Heights Circle ~ Anchorage ~ Alaska 99504
Phone (907) 337-6179 ~ Fax (907) 338-3246
Consulting Engineers
February13,1998
Charlene Derry
P.O. Box 770513
Eagle River, Alaska 99577
Subject: Well & Septic System Inspection at Lot 10, Bk 2, Glacier View Heights 04
Dear Ms. Derry:
Per your request we performed adequacy tests on the subject well and septic system. The results
of the field investigation and adequacy tests are summarized as follows:
A. WELL: The static water level on 2/9/98 was 38 feet below the top of the casing (BTC).
Water was pmnped from the well at a rate of 4.97 gpm for a total of 246 minutes (1222 gallons).
During the entire pumping period the drawdown varied from 1 to 2 feet. Based upon this data it
was determined that the capacity of the well exceeds the Municipal requirements for a 3 bedroom
house (450 gallons per day), and exceeds the FHA financing requirement of 3 gpm for 4 hours.
B. SEPTIC SYSTEM ADEQUACY TEST: The drainfield is a shallow trench type system that
was installed in July of 1984, making it approximately 13.5 years old. According to the M.O.A
documents, the trench is 5 feet wide, 60 feet long, mad has an effective depth of 18 inches. When
initially inspected on 2/9/98 there was 24 inches of liquid in the sump, which is an indication that
the trench was surcharged (liquid level above the drah~pipe). Initially we could not find the
clean-out at the beginning of the trench to observe whether it was submerged in water. To further
verify that the trench was failed we introduced water into the septic tank (lst compartment
clean-out) at a rate of 4.93 gpm for 61 minutes (301 gallons), at which time we fotmd the
clean-out at the beginning of the trench. It was then noted that there was 5 inches of liquid in the
clean-out at the beginning of the trench, and 32 inches in the smnp. Based upon this data is was
determined that the drainfiekl is failed.
The options available at this time are to install a new drainfield, or attempt to rejuvenate the
existing one. Rejuvenation of the existing system would require jet cleaning of the drainpipes, and
the introduction of a chemical such as Septiclear (phosphoric and sulfuric acid) or hydrogen
peroxide. Given the porosity of the soil (rated at 125 square feet per bedroom) I think you have a
good chance of rejuvenating the system, but there is no guarantee that it will work. It is my
recommendation that you contact Old McDonalds Pumping (338-4476) or Isaac's Pumping
(563-5500) regarding the jetting and chemical treatment. You should expect to pay around
$1000.00 for their services; however, if it is successful, you will save thousands of dollars.
The M.O.A won't issue a HAA on a chemically treated system until it has been used for at least
30 days and retested. If the rejuvenation doesn't work, a new drainfield will need to be
designed/constructed. If ~ou have any questions, please contact me at 337-6179, or 244-9612.
Sincerel~~
Principal
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
Application Date /<~_,~i/.~. <~ .
1.
General
Information
(a) Legal Description (include lot, block, subdivis.ion, section, township, range)
Location (address or directions)
(b) Applicants a,ne~~]Li2 Tele~one -Home Busine. s~s~~_~
Applicants Address~~~ IZt~i~~P~ At~'~ ~?~ ~z
/ ~
(c) Applicant is (check one)Lending Institution ~] ; ~/~ii(~ ~ ;
Buyer ~ ; Other ~ (explain); ~-
(d) Lending Institution ~~] Telephone
Address
(e) Real Estate Co. & Agent __~~~__.__
Address
(f)
Telephone
Mail Che HAA to the following address:
2. T~of R_____esidence.
Number of Bedrooms
3. W_acer Sup_~j!
I nd ividual Wel 1'~
Other (describe)
Community~--~ Public~__~
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the ].egalit~ and status.
Sewage I)is~al
Note: If community well. system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legslity and status.
[Page 1 of 2]
Engineering. Firm Providi_n~_~ns~ctions~ Test~ File Search_~ Data and Information
As certified by my seal affixed hereto and as of the validation date shown below, I
verify that my investigation of this Health Authority Approval shows that the on-site
water supply and/or wastewater disposal system is safe, functional and adequate for
the number of bedrooms and type of structure indicated herein. I further verify that,
based on the information obtained from the Municipality of A~chorage files and from my
investigation and inspection, the on-site water supply and/or wastewater disposal
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect: on the date of this inspection.
Name of Firm
Address ~J) ~
Date~ Ar ~z
DHEP App, rova~i
Approved for-7~xT~'.5~ bedrooms
Approved .~ ~ Disapproved
Telephone
(ENGINEER SEAL) f/''~7'4';: '~'. , ~. ' A '
~, __ Conditional
Terms of Conditional Approval
CAUT I 0 N
'.['HE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HF, AI, TH AND ENVIRONbfENTAL PROTECTION
(DHEP) ISSUES ~IALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESS-~ONA----~ ENGINEER REGISTERED
IN THE STATE OF AI~ISKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEF, S 017 DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A
CERTIFICATE IS ISSUED. TIlE MUNICIPALITY OF ANCHORAGE IS NOT RESPONS!BIJ~ FOR ERRORS
OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK.
(DNEP SF~AL)
RR4/ej/D18
[Page 2 of 2]
7-1 9-84
ae
I'i'DV
8 984
HEALTH ALK[~ORITY APPROVAL (HAA)
CHECKLIS]~ - FEBRUARY 1984
Legal Description:
Well Classification_ ~;-]¥~,~ If A, B, o~ C, D.E.C. Approved(Y/N)
Well Log P~esent .(Y/N) .~' Date Completed /~ &~ ~/
Total Depth ~2kdp / Cased to ~ / Q / Depth of G~outing
Static Water Level _ ~ _~- / Pump Set At /~
Casing Height Above G~ound ~ / Sanitary Seal on Casing (Y/N) .~_
Electrical Wi~ing in Conduit (Y/N) y Depression Around Wellhead (Y/N) '~_
Separation Distances f~om Well:
To Septic/Holding Tank on Lot /aD ~ ; On Adjoining Lots /~
To Nearest Edge of Absorption Field on Lot /~ ; On Adjoining Lots
To Nearest Public Sew~ Line /~/'~ To Nearest Public Sewer
Cleanout/Manhole /~'/~'~'~ To Nearest Sewe~ Service Line on Lot ~ '~''
Wate~ Sample Collected. By Z~9 ,,,~ .~ ~.. ; Date ~oX/ ,% '.3./,~'~ _
Wate~ Sample Test Results J'~ ~,~ ~.~.~,:,
C~uents
B. SEPTIC/HOLDING TANK DATA
Date Installed / ? ~' H Size /~ ~)~) ¢~¢,// No. of C~,%3a~tments
Standpipes (Y/N) .~ Air-tight Caps (Y/N) ~v Foundation Cleanout (Y/N) ,~ _
Depression ove~ Tank (Y/N) N Date Last Pumped
Pumping/Maintenance Contract on File (Y/N)/V/~ ; fo~
Holding Tank High-Wate~ Alarm (Y/N) ~J//~ Temporary Holding Tank Permit (Y/N)
Separation Distances f~om Septic/Holding Tank: -
To Water-Supply Well /Od ~-~
To Property Line /o ~
To ~ater Main/Service Line t(~ '~
Course FF~_
To Building Foundation '~J g/A'~ /
To Disposal Field ._,~ /
To Stream, Pond, Lake, c~ Major Drainage
[Page 1 of 2]
2-15-84
Ce
ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed / ~) & ~/
Width of Field ~ '
Square Feet of Absorption A~ea
/ ~k &- ~ Type of System Design
Length of Field f~ ~
Depth of Field .5-~', 5~
?
Gravel Bed Thickness /, 5-
Standpipes P~esent (Y/N)
Depression over Field (Y/N) /%/ Date of Last Adequacy Test
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well /~ '/J' To P~operty Line /~./~
To Building Foundation ~ ~ To Existing or Abandoned System
Lot A/~ ,,.-,-e ; On Adjoining Lots .~ ~ ~
To Wate~ Main/Service Line /~ ~'- TO Cutbank(if present)
TO Stream/Pond/Lake/c~ Major Dr~ainage Course
To D~iveway, Parking A~ea, or Vehicle Storage A~ea __~'~ W
Comments /~ ~,' t-
LIFT STATION A//~
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes(Y/N)
Cc~ents
Dim~ ns ions
Manhole/Access (Y/N)
"Pump. Off" Level at
Vent (Y/N)
Pu~ping Cycles du~ing Adequacy Test.
~ets MOA
** Check Permitted Bedroc~ Rating Against HAA Request **
'I certify that I have checked,~rified, o~ conformed to all MOA HAA Guidelines in effect
on the date of this inspection~ /
Signed Date
[Page 2 of 2] -.
2-15-84
